Mini-ACE: Validation Study Among Older People in Long-Term Care.

Background: The Mini-Addenbrooke's Cognitive Examination (M-ACE) is a valid and reliable tool that accurately differentiates various types of cognitive impairment from Normal-cognition assessed in multiple settings. However, its validity among older individuals in long-term care (LTC) was not yet established. Therefore, we sought to assess the Portuguese M-ACE's validity, reliability, and accuracy in detecting cognitive impairment no-dementia (CIND) in LTC users. Methods: A comprehensive assessment was performed on 196 LTC Portuguese users aged ≥ 60 years, among whom 71 had Normal-cognition, and 125 had CIND. Results: The M-ACE was found to be reliable (McDonald's ω = .86, Cronbach's α = .85) and consistent over time (r = .72; ICC = .83) and between raters (k = .92). Strong correlations with related measures supported construct validity (both r = .67). The M-ACE accurately distinguished CIND from Normal-cognition with a cut-off of 17 points (AUC = 0.81, Sensitivity = 81.7%, Specificity = 74.4%). Conclusion: Our findings suggest that the Portuguese M-ACE is a valid and reliable cognitive assessment tool for LTC users, allowing for accurate differentiation between CIND and Normal-cognition. Thus, the M-ACE's use could contribute to the early detection and intervention of cognitive disorders, especially among older adults in LTC.

Emotion dysregulation in older people: validity and reliability of an 8-item version of the Difficulties in Emotion Regulation Scale.

OBJECTIVES: The abbreviated 16-item version of the Difficulties with Emotion Regulation Scale (DERS-16) is widely used to assess individuals' perceived challenges in regulating their emotions, a central aspect of psychological symptoms commonly experienced in old age. However, its psychometric properties have yet to be tested in this population. Furthermore, a shorter version of the DERS-16 could further minimize the assessment burden on older individuals. Thus, we aimed to test the DERS-16's psychometric performance and determine if any items were redundant to develop a psychometrically sound shorter version. METHODS: We enrolled 302 Portuguese older adults (Mage = 75.22; SD = 8.99 years) in a cross-sectional study. RESULTS: Exploratory factor analyses indicated a one-factor structure and a four-factor solution with eight items (69.3%-81.9% of the variance observed). The four-factor-8-item solution presented an interpretable structure and demonstrated good reliability values (> 0.70) and construct validity with the Twenty-Item Toronto Alexithymia Scale, Eight-Item Geriatric Depression Scale, and Geriatric Anxiety Inventory (r = 0.66, 0.40, 0.52; p < 0.001). CONCLUSION: The robust psychometric properties of DERS-8 make it a valuable tool for clinical and longitudinal studies, facilitating targeted interventions in older adults and allowing for precise emotion dysregulation screening.

Does emotional dysregulation mediate the relationship between disability and depressive symptoms in older people? / ¿La desregulación emocional media la relación entre la discapacidad y los síntomas depresivos en las personas mayores?

Background: Emotion dysregulation has been consistently linked to psychopathology, and the relationship between disability and depressive symptomatology in old age is well-known. Objective: To examine the mediational role of emotional dysregulation in the relationship between perceived disability and depressive symptomatology in older adults. Methods: Two hundred eighty-three participants, aged 60–96 years (M±SD=74.22±8.69; 62.9% women; 29.0% with long-term care support [LTC-S] and 71.0% community residents without LTC-S), were assessed with the Geriatric Depression Scale-8 (GDS-8), the World Health Organization Disability Assessment Schedule-2 (WHODAS-2), and the Difficulties in Emotion Regulation Scale-16 (DERS-16). Results: A mediation model was established, which revealed: (1) a moderate association between WHODAS-2 and GDS-8 (β=0.20; p<.001); (2) DERS-16 partially and weakly mediated the relationship between WHODAS-2 and GDS-8 (β=0.003; p<.01). The model explained 31.9% of the variance of depressive symptoms. An inconsistent mediation model was obtained in the LTC-S group. Conclusions: Globally, our findings indicate that disability has an indirect relationship with depressive symptomatology through emotional dysregulation (except for those in the LTC-S). Accordingly, we present suggestions for the treatment of depressive symptoms and for the inclusion of other emotion regulation variables in the study of the disability-depressive symptom link in future studies with older people in the LTC-S. (AU)

Antecedentes: La desregulación de las emociones se ha relacionado sistemáticamente con la psicopatología, y es bien conocida la relación entre la discapacidad y la sintomatología depresiva en la edad avanzada. Objetivo: Examinar el papel mediador de la desregulación emocional en la relación entre la discapacidad percibida y la sintomatología depresiva en los adultos mayores. Materiales y métodos: Doscientos ochenta y tres participantes, entre 60-96 años de edad (M±DE=74,22±8,69; 62,9% mujeres; 29% con apoyo de cuidados de larga duración [A-CLD] y 71% residentes en la comunidad sin A-CLD), fueron evaluados con la Geriatric Depression Scale-8 (GDS-8), el World Health Organization Disability Assessment Schedule-2 (WHODAS-2) y la Difficulties in Emotion Regulation Scale-16 (DERS-16). Resultados: Se estableció un modelo de mediación que reveló: (1) una asociación moderada entre el WHODAS-2 y el GDS-8 (β=0,20; p<0,001); (2) el DERS-16 medió parcial y ligeramente la relación entre el WHODAS-2 y el GDS-8 (β=0,003; p<0,01). El modelo explicó el 31,9% de la varianza de los síntomas depresivos. Se ha obtenido un modelo de mediación inconsistente en el grupo A-CLD. Conclusiones: Globalmente, nuestros hallazgos indican que la discapacidad tiene una relación indirecta con la sintomatología depresiva a través de la desregulación emocional. En consecuencia, presentamos sugerencias para el tratamiento de los síntomas depresivos y para la inclusión de otras variables de regulación de las emociones en el estudio del vínculo discapacidad-síntomas depresivos en futuros estudios con personas mayores en el A-CLD. (AU)

Does emotional dysregulation mediate the relationship between disability and depressive symptoms in older people?

BACKGROUND: Emotion dysregulation has been consistently linked to psychopathology, and the relationship between disability and depressive symptomatology in old age is well-known. OBJECTIVE: To examine the mediational role of emotional dysregulation in the relationship between perceived disability and depressive symptomatology in older adults. METHODS: Two hundred eighty-three participants, aged 60-96 years (M±SD=74.22±8.69; 62.9% women; 29.0% with long-term care support [LTC-S] and 71.0% community residents without LTC-S), were assessed with the Geriatric Depression Scale-8 (GDS-8), the World Health Organization Disability Assessment Schedule-2 (WHODAS-2), and the Difficulties in Emotion Regulation Scale-16 (DERS-16). RESULTS: A mediation model was established, which revealed: (1) a moderate association between WHODAS-2 and GDS-8 (ß=0.20; p<.001); (2) DERS-16 partially and weakly mediated the relationship between WHODAS-2 and GDS-8 (ß=0.003; p<.01). The model explained 31.9% of the variance of depressive symptoms. An inconsistent mediation model was obtained in the LTC-S group. CONCLUSIONS: Globally, our findings indicate that disability has an indirect relationship with depressive symptomatology through emotional dysregulation (except for those in the LTC-S). Accordingly, we present suggestions for the treatment of depressive symptoms and for the inclusion of other emotion regulation variables in the study of the disability-depressive symptom link in future studies with older people in the LTC-S.